Treatments Other Than Medication Or Surgery
Staying active and pursuing therapy can help you adjust your lifestyle with Parkinson’s disease. We offer a full range of therapy and other services to help you, including:
- Exercise, physical, occupational and recreational therapy to keep you mobile, living your life and doing things your enjoy
- Nutrition and speech therapy to help with throat and swallowing issues.
- Mental health support and social services to treat depression and anxiety stemming from disease-related challenges, such as lifestyle changes.
Learn more about the nonsurgical- and nonmedication-based Parkinson’s disease programs we offer. Talk to your care team about these and additional options.
We will also provide you with resources to manage your Parkinson’s Disease including new patient orientation, classes, support groups and links to national associations.
What Is Parkinsonism Characterized By
Parkinsonism is characterized by the loss of dopamine, a neurotransmitter that helps regulate movement.
Without dopamine, a person will experience the symptoms of bradykinesia, rigidity, and tremors that are characteristic of Parkinsonism.
The exact cause of the damage to dopamine-producing cells is unknown and likely differs from person to person.
Does Cbd Help Parkinsons
CBD hasnt been used in Parkinsons Disease patients long term, and there are few studies to rely on for treatment guidance. Recently, a Phase II clinical trial was completed on CBDs role in the treatment of Parkinsons Disease. Treatment outcomes were positive for sleep, depression, behavior and emotion, anxiety, and cognition. Improvements in psychotic features were seen as well.
About 20-40% of PD patients experience psychotic symptoms. And, treatment with antipsychotics may bring out Parkinson-like symptoms. Taking CBD may relieve pain associated with PD, although research favors THC for this effect.
CBD oil for Parkinsons symptom treatment can be in the form of edibles, oils, tinctures, ointments, vape cartridges, and creams. Topical CBD can be used for muscle spasms so common in patients with PD, and oils can be used to relieve symptoms faster.
However, data is lacking regarding this mode of delivery. Tinctures also offer speedy effects as a way to take CBD. The only FDA-approved way of taking CBD, however, is through the drug Epidiolex although its benefits have been shown from other CBD oils.
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How Is Parkinson Disease Diagnosed
Parkinson disease can be hard to diagnose. No single test can identify it. Parkinson can be easily mistaken for another health condition. A healthcare provider will usually take a medical history, including a family history to find out if anyone else in your family has Parkinsons disease. He or she will also do a neurological exam. Sometimes, an MRI or CT scan, or some other imaging scan of the brain can identify other problems or rule out other diseases.
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What Are Signs And Symptoms Of Parkinsons Disease
Early diagnosis can greatly increase the effectiveness of Parkinsons treatment. However, Parkinsons symptoms are easy to dismiss as normal signs of aging or other conditions such as stroke or head trauma. For these reasons, people may ignore symptoms or doctors may have a harder time with diagnosis.
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Other Causes Of Parkinsonism
“Parkinsonism” is the umbrella term used to describe the symptoms of tremors, muscle rigidity and slowness of movement.
Parkinson’s disease is the most common type of parkinsonism, but there are also some rarer types where a specific cause can be identified.
These include parkinsonism caused by:
- medication where symptoms develop after taking certain medications, such as some types of antipsychotic medication, and usually improve once the medication is stopped
- other progressive brain conditions such as progressive supranuclear palsy, multiple systems atrophy, and corticobasal degeneration
- cerebrovascular disease where a series of small strokes cause several parts of the brain to die
You can read more about parkinsonism on the Parkinson’s UK website.
Medications For People With Parkinsons Disease
Symptoms of Parkinsons disease result from the progressive degeneration of nerve cells in the brain and other organs such as the gut, which produce a neurotransmitter called dopamine. This causes a deficiency in the availability of dopamine, which is necessary for smooth and controlled movements.
Medication therapy focuses on maximising the availability of dopamine in the brain. Medication regimes are individually tailored to your specific need. Parkinsons medications fit into one of the following broad categories:
- levodopa dopamine replacement therapy
- dopamine agonists mimic the action of dopamine
- COMT inhibitors used along with levodopa. This medication blocks an enzyme known as COMT to prevent levodopa breaking down in the intestine, allowing more of it to reach the brain
- anticholinergics block the effect of another brain chemical to rebalance its levels with dopamine
- amantadine has anticholinergic properties and improves dopamine transmission
- MAO type B inhibitors prevent the metabolism of dopamine within the brain.
There is no best medication treatment for Parkinsons. Each person has different symptoms, disease progression, lifestyle and physical tolerances. All of these factors will affect the timing, type, dose and combinations of medication.
As the disease progresses, your doctor will need to review and alter your medication program. Its is important to see a neurologist or a doctor who has experience in helping people with Parkinsons disease.
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The Benefits Of Alternative Treatment
There is no cure for Parkinsons but genetic testing can be done to assess your risk for early diagnosis. In conventional medicine, Parkinsons treatment is focused on slowing down the progression of the disease through medications that either imitate dopamine in the brain, convert to dopamine in the brain, or slow down the breakdown of dopamine.
The problem with these medications is that they often have their own set of side effects that can be equally as debilitating to live with as Parkinsons symptoms with hallucinations being the one of them. But the question is, can you live with Parkinsons without medication? If so, can Parkinsons disease be reversed naturally?
In functional medicine we aim to both slow down progression and put symptoms into remission without the need for medication. While sometimes medication is necessary, we look for solutions that offer the least amount of side effects that are still effective at addressing symptoms. Sometimes a combination of medication and natural solutions are needed depending on how far along Parkinsons has progressed and sometimes alternative solutions can be enough to be effective.
Monoamine Oxidase Type B Inhibitors
MAO B inhibitors, such as Zelapar , Azilect , and Xadago , are typically considered for milder or less-advanced cases. Dosages vary based on type. For instance, 5 mg of Zelapar twice a day is currently the recommended indication.
Potential side effects of MAO B inhibitors are similar to other therapies and include headache, nausea, confusion, hallucinations, and dyskinesia.
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When Should I See My Healthcare Provider About Lewy Body Dementia
If you or a loved one are experiencing symptoms of Lewy body dementia, talk to your healthcare provider.
If youve been diagnosed with Lewy body dementia, youll need to see your healthcare team regularly to monitor your health and symptoms and to make sure your medications are working.
A note from Cleveland Clinic
Learning early that you have a diagnosis of Lewy body dementia allows you and your family to plan for a meaningful quality of life together and enables you to get your legal, financial and healthcare plans and desires in order. Your healthcare team will be ready to provide education, support and care for you or your loved one. Ask your team for information on local LBD support groups as well. Support groups can be very helpful for sharing care tips and providing comfort in knowing youre not alone.
Last reviewed by a Cleveland Clinic medical professional on 08/18/2022.
References
- Genetic and Rare Diseases Information Center. Lewy Body Dementia. Accessed 8/18/2022.
- Haider A, Spurling BC, Sánchez-Manso JC. Lewy Body Dementia. . In: StatPearls . Treasure Island : StatPearls Publishing 2022. Accessed 8/18/2022.
- Merck Manual Professional Version. Lewy Body Dementia and Parkinson Disease Dementia. Accessed 8/18/2022.
- National Institutes of Neurological Disorders and Stroke. Dementia with Lewy Bodies Information Page. Accessed 8/18/2022.
- National Institute on Aging. What Is Lewy Body Dementia? Causes, Symptoms, and Treatments. Accessed 8/18/2022.
Support For People With Parkinsons Disease
Early access to a multidisciplinary support team is important. These teams may include doctors, physiotherapists, occupational therapists, speech therapists, dietitians, social workers and specialist nurses.
Members of the team assess the person with Parkinsons disease and identify potential difficulties and possible solutions.
There are a limited number of multidisciplinary teams in Victoria that specialise in Parkinsons disease management. But generalist teams are becoming more aware of how to help people with Parkinsons disease.
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Core Features Of Probable Pdd
The primary defining feature of PDD is dementia that develops in the setting of established PD . Therefore, the critical first step in the diagnosis process is to identify idiopathic PD, prior to the development of dementia. For a diagnosis of PDD, two core features must be present: a diagnosis of PD according to the Queen Square Brain Bank criteria and PD developed prior to the onset of dementia .
In this case, a dementia syndrome is defined as impairment in at least two cognitive domains and cognitive deficiency severe enough to impair daily life that must be independent of impairment because of PD motor symptoms. The MDS Task Force recommended that the Mini-Mental State Examination may be useful as a screening instrument for identifying cognitive impairment in PDD patients the MMSE is a simple and universally applied scale that can be easily and quickly performed in the clinical setting . An MMSE score of 25 or below is proposed as the cut-off for identifying clinically significant cognitive impairment in this population .
Parkinson’s Disease And Movement Disorders Center
Our center provides compassionate and timely treatment to patients with movement disorders, such as dystonia, ataxia, essential tremor and similar conditions. But our mission goes beyond patient care excellence. By offering educational events and support groups, we empower patients and caregivers to become better partners in their health.
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What Causes The Condition
Although there are several recognized risk factors for Parkinsons disease, such as exposure to pesticides, for now, the only confirmed causes of Parkinsons disease are genetic. When Parkinsons disease isnt genetic, experts classify it as idiopathic . That means they dont know exactly why it happens.
Many conditions look like Parkinson’s disease but are instead parkinsonism from a specific cause like some psychiatric medications.
Familial Parkinsons disease
Parkinsons disease can have a familial cause, which means you can inherit it from one or both of your parents. However, this only makes up about 10% of all cases.
Experts have linked at least seven different genes to Parkinson’s disease. They’ve linked three of those to early-onset of the condition . Some genetic mutations also cause unique, distinguishing features.
Idiopathic Parkinsons disease
Experts believe idiopathic Parkinsons disease happens because of problems with how your body uses a protein called -synuclein . Proteins are chemical molecules that have a very specific shape. When some proteins dont have the correct shape a problem known as protein misfolding your body cant use them and can’t break them down.
With nowhere to go, the proteins build up in various places or in certain cells . The buildup of these Lewy bodies causes toxic effects and cell damage.
Induced Parkinsonism
The possible causes are:
How Does This Condition Affect My Body
Parkinsons disease causes a specific area of your brain, the basal ganglia, to deteriorate. As this area deteriorates, you lose the abilities those areas once controlled. Researchers have uncovered that Parkinsons disease causes a major shift in your brain chemistry.
Under normal circumstances, your brain uses chemicals known as neurotransmitters to control how your brain cells communicate with each other. When you have Parkinsons disease, you dont have enough dopamine, one of the most important neurotransmitters.
When your brain sends activation signals that tell your muscles to move, it fine-tunes your movements using cells that require dopamine. Thats why lack of dopamine causes the slowed movements and tremors symptoms of Parkinson’s disease.
As Parkinson’s disease progresses, the symptoms expand and intensify. Later stages of the disease often affect how your brain functions, causing dementia-like symptoms and depression.
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Who Does It Affect
The risk of developing Parkinsons disease naturally increases with age, and the average age at which it starts is 60 years old. Its slightly more common in men or people designated male at birth than in women or people designated female at birth .
While Parkinsons disease is usually age-related, it can happen in adults as young as 20 .
Dementia With Lewy Bodies
DLB is a progressive neurodegenerative condition that involves the accumulation of an abnormal protein called alpha-synuclein in various parts of the brain. Although the protein also builds up in the brains of people with Parkinsons disease, it occurs later in that disease than in DLB.
The first manifestation of DLB is worsening problems with thinking and memory. Other symptoms include recurring visual hallucinations and fluctuating alertness during the day. As the condition progresses, symptoms similar to those of Parkinsons disease, such as stiffness and slow movement, appear.
DLB has no specific treatment. Doctors may prescribe the main treatment for Parkinsons disease, although it is less likely to be effective.
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When Should You See A Doctor
Sometimes constipation can be a symptom of more severe illness, including colorectal and other types of cancer. See your doctor or other health care provider if your bowel habits change and are accompanied by any one of the following:
Visit the NIH National Institute of Diabetes and Digestive and Kidney Diseases educational page on constipation for more information on possible causes and treatments.
Treatment And Care For Lewy Body Dementia
While LBD currently cannot be prevented or cured, some symptoms may respond to treatment for a period of time. An LBD treatment plan may involve medications, physical and other types of therapy, and counseling. A plan to make any home safety updates and identify any equipment can make everyday tasks easier.
A skilled care team often can suggest ways to improve quality of life for both people with LBD and their caregivers.
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What Are The Causes
Drug-induced parkinsonism is caused by medications that reduce dopamine levels in the brain. Dopamine is a neurotransmitter that works to control bodily movements.
Dopamine is also part of the brains reward system. It helps you feel pleasure and enjoyment, and it supports your ability to learn and focus.
Medications that bind to and block dopamine receptors are called dopamine antagonists. These medications arent used to treat Parkinsons disease. Rather, theyre used to treat other conditions that might seriously impact your quality of life.
If your doctor has prescribed a medication that causes unwanted side effects, you may have options. You may also decide that the side effects are worth it if the medication effectively treats your condition.
Some medications that cause drug-induced parkinsonism include:
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What Are The Complications Of Parkinson Disease
Parkinson disease causes physical symptoms at first. Problems with cognitive function, including forgetfulness and trouble with concentration, may arise later. As the disease gets worse with time, many people develop dementia. This can cause profound memory loss and makes it hard to maintain relationships.
Parkinson disease dementia can cause problems with:
- Speaking and communicating with others
- Problem solving
- Paying attention
If you have Parkinson disease and dementia, in time, you likely wont be able to live by yourself. Dementia affects your ability to care of yourself, even if you can still physically do daily tasks.
Experts dont understand how or why dementia often occurs with Parkinson disease. Its clear, though, that dementia and problems with cognitive function are linked to changes in the brain that cause problems with movement. As with Parkinson disease, dementia occurs when nerve cells degenerate, leading to chemical changes in the brain. Parkinson disease dementia may be treated with medicines also used to treat Alzheimers disease, another type of dementia.
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How Is Parkinsons Diagnosed
Doctors use your medical history and physical examination to diagnose Parkinsons disease . No blood test, brain scan or other test can be used to make a definitive diagnosis of PD.
Researchers believe that in most people, Parkinsons is caused by a combination ofenvironmental and geneticfactors. Certain environmental exposures, such as pesticides and head injury, are associated with an increased risk of PD. Still, most people have no clear exposure that doctors can point to as a straightforward cause. The same goes for genetics. Certain genetic mutations are linked to an increased risk of PD. But in the vast majority of people, Parkinsons is not directly related to a single genetic mutation. Learning more about the genetics of Parkinsons is one of our best chances to understand more about the disease and discover how to slow or stop its progression.
Aging is the greatest risk factor for Parkinsons, and the average age at diagnosis is 60. Still, some people get PD at 40 or younger.
Men are diagnosed with Parkinsons at a higher rate than women and whites more than other races. Researchers are studying these disparities to understand more about the disease and health care access and to improve inclusivity across care and research.
Aging is the greatest risk factor for Parkinsons, and the average age at diagnosis is 60. Still, some people get PD at 40 or younger.
The Michael J. Fox Foundation has made finding a test for Parkinsons disease one of our top priorities.